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Kuckein Student Research Fellowship"],"award-info":[{"award-number":["Carolyn L. Kuckein Student Research Fellowship"]}],"id":[{"id":"10.13039\/100005332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002732","name":"AOSpine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n<jats:italic>Staphylococcus aureus<\/jats:italic> and <jats:italic>Streptococcus agalactiae<\/jats:italic> (Group B streptococcus, GBS) are common causes of deep musculoskeletal infections (MSKI) and result in significant patient morbidity and cost to the healthcare system. One of the major challenges with MSKI is the lack of faithful diagnostics to correctly identify the primary pathogen, as standard culture\u2010based assays are prone to false positives in the case of polymicrobial infections, and false negatives due to limitations in sample acquisition and antibiotic use before presentation. To improve upon our current diagnostic methods for MSKI, we developed a multiplex immunoassay for antigen\u2010specific IgGs in serum (Luminex), and medium enriched for newly synthesized antibodies (MENSA) for anti\u2010<jats:italic>S. aureus<\/jats:italic> and GBS generated from cultured peripheral blood mononuclear cells (PBMCs) of orthopedic infection patients undergoing surgical treatment. Samples were obtained from 110 MSKI patients: 80 diabetic foot ulcer, 21 periprosthetic joint infection, 5 septic arthritis, 2 spine, 1 hand, and 1 fracture\u2010related infection (FRI). Anti\u2010<jats:italic>S. aureus<\/jats:italic> and anti\u2010GBS antibody titers were compared to culture results to assess their concordance in identifying the pathogens. Immunoassay, particularly MENSA, showed high diagnostic potential for monomicrobial <jats:italic>S. aureus<\/jats:italic> and GBS orthopedic infections (AUC\u2009&gt;\u20090.95). MENSA also demonstrated diagnostic potential for GBS polymicrobial orthopedic infection and for GBS DFU (AUC\u2009&gt;\u20090.83 for both). Serum showed high diagnostic potential for <jats:italic>S. aureus<\/jats:italic> PJI (AUC\u2009&gt;\u20090.95). Taken together, these findings support the development of species\u2010specific immunoassays for the identification of causal pathogens in active MSKI, especially in conjunction with standard culture.<\/jats:p>","DOI":"10.1002\/jor.24935","type":"journal-article","created":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T10:54:57Z","timestamp":1607079297000},"page":"2141-2150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical utilization of species\u2010specific immunoassays for identification of <i>Staphylococcus aureus<\/i> and <i>Streptococcus agalactiae<\/i> in orthopedic infections"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-2675","authenticated-orcid":false,"given":"Aron","family":"Sulovari","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal Research University of Rochester Medical Center  Rochester New York USA"},{"name":"Department 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M.","family":"McDowell","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Research University of Rochester Medical Center  Rochester New York USA"},{"name":"Department of Orthopaedics and Rehabilitation University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Research University of Rochester Medical Center  Rochester New York USA"},{"name":"Department of Orthopaedics and Rehabilitation University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9690-7701","authenticated-orcid":false,"given":"John L.","family":"Daiss","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Research University of Rochester Medical Center  Rochester New York USA"},{"name":"Department of 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